Endoscopic hemorrhoidal ligation: preliminary clinical experience

Endoscopic hemorrhoidal ligation may provide an alternative to surgical treatment of internal hemorrhoids. This study assessed the safety and efficacy of endoscopic elastic band ligation for bleeding internal hemorrhoids.

Endoscopic hemorrhoid ligation was performed in 20 adult patients who had chronic rectal bleeding attributed to internal hemorrhoids. Elastic band ligation was accomplished using a ligating device attached to the end of a video endoscope. Repeat endoscopy was done 3 weeks after the initial procedure.

Seventy band ligations were performed during 23 separate sessions. Post-therapy endoscopy showed reduction of hemorrhoidal size by at least one grade in 19 of 20 patients (95%). Bleeding resolved in 19 of 20 patients (95%) in 5.4 months (mean) of follow-up; 18 of 20 (90%) required only one banding session. No major complications (perforation, secondary bleeding, deep ulceration) occurred in this small group.

Preliminary data indicates that endoscopic hemorrhoidal ligation is a safe and effective technique for treating internal hemorrhoids. It holds promise as an important technique for successfully treating and possibly eradicating symptomatic internal hemorrhoids.